Related questions with answers

J.H., a 53-year-old man, comes to the primary care provider's office for his annual physical. He has a history of familial hypercholesteremia for which he takes atorvastatin. His only other medication is a once-daily, low-dose aspirin. During the initial intake, he tells you his greatest concern is that he cannot get an erection. He states, "my wife and I have only had sex a few times in the past 6 months!"

J.H. says the quality of his erections and the ability to keep an erection has been worsening over the past year. When he does have an erection sufficient for intercourse, he says it is less firm but ejaculatory function and sensations are normal. There are no morning or nocturnal erections. He denies any problems with libido or a history of trauma, STIs, or UTIs.

J.H. is $6 \mathrm{ft}, 3$ in $(190.5 \mathrm{~cm})$ and weighs $250 \mathrm{lb}(113 \mathrm{~kg})$ . His physical assessment is otherwise unremarkable. He has a normal, circumcised penis without any discharge or lesions. His testes are bilaterally descended, with normal size and texture. Perianal sensations are intact. The digital rectal exam completed by the provider shows no prostate enlargement or nodules. His femoral and pedal pulses are all $2+$ . His VS are $140 / 80,90,16,97.7^{\circ} \mathrm{F}\left(36.5^{\circ} \mathrm{C}\right)$ . What teaching will you provide J.H. about the safe use of sildenafil?